1. Field of the Invention
This invention relates generally to surgical attachment devices and more specifically to T-anchors adapted for maintaining body walls in proximity.
2. Discussion of the Prior Art
A T-anchor is a surgical device used for moving two body walls into proximity and for maintaining those two walls in proximity for an extended period of time. Such an apparatus could be valuable for many surgical procedures such as the installation of a feeding tube into the stomach of a patient as disclosed and claimed by applicant in U.S. Pat. No. 5,429,598 issued on Jul. 4, 1995, and entitled Surgical Access Device and Procedure. In this procedure, a T-anchor could be used to move the wall of the stomach into proximity with the abdominal wall prior to installation of a feeding tube.
The T-anchor typically consists of an anchor bar having a longitudinal configuration and a suture attached to the bar and extending laterally from the bar. An introducer can be used to pass the anchor bar through the two walls and to deploy the anchor bar on the far side of the second wall. The suture is left to extend through the two walls, and is provided with a bolster on the near side of the two walls which is slidable along the suture. As the suture is pulled and the bolster is pushed, the anchor bar seats against the second wall which is drawn into proximity with the first wall. A knot tied in the suture on the proximal side of the bolster maintains the anchor in this operative position with the two walls in close proximity.
In the past, the T-anchor has been loaded into the proximal end of a hollow needle which has been inserted through the two walls. The anchor bar was then expelled using a guidewire, from the lumen of the needle on the far side of the second wall. In this system the suture attached to the anchor bar, extends proximally through the entire lumen of the needle. After the anchor bar has been deployed, the needle is withdrawn backwardly through the two walls and along the suture. The bolster is then threaded onto the suture and the procedure completed as previously noted.
In this embodiment of the T-anchor assembly, the lumen of the needle or introducer must be sufficiently large to accommodate not only the diameter of the anchor bar, but also the diameter of the suture. Both of these elements must occupy space side-by-side within the lumen. This requirement for an increased inside diameter of the lumen has of course demanded a larger outside diameter for the needle.
It is always of interest to simplify apparatus and procedures for medical application since this ultimately results in reduced time, trauma and cost. It is also of interest to reduce the size of incisions or punctures required by various procedures in order to promote healing and reduce trauma for the patient.